Chareunphone T Inthirat, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN013619 Issued in GA

Practice address

405 Arrowhead Blvd
Jonesboro, GA 30236-1254

Phone

(404) 545-1769

NPI assigned

Sep 10, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Children and Teen Dental Group

  • General Practice Dentistry
  • Cornelia, GA
  • NPI 1255139432
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189382400000",
    "number": "1568657807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 ARROWHEAD BLVD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361254",
            "telephone_number": "404-545-1769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 ARROWHEAD BLVD",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302361254",
            "telephone_number": "404-545-1769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INTHIRAT",
        "first_name": "CHAREUNPHONE",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-10",
        "last_updated": "2007-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013619",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrity Behavior Health Outpatient Center
• Integrity Garden Diagnostic and Lab LLC
• Integrity Garden Home Care LLC
• International Center for Foot & Ankle Surgery
• Interventional Institute of Georgia
• Intuitive Choice Physical Therapy and Wellness, LLC
• Inwood Therapeutic Services LLC
• Titi A Ipadeola
• Sohail Iqbal, M.D
• Ashley Lauren Irvin, PTA

• General Practice Dentistry in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.